DR. JAEKYUNG SONG (M.D.) – Internal Medicine Physician, NPI 1972700656
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,058 INTERNAL MEDICINE in WA
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Provider Addresses for DR. JAEKYUNG SONG (M.D.)
3360, Southwest 87th Avenue, Raleigh West, Portland, Metro, Washington County, Oregon, 97225, United States
PORTLAND, OR 972083360
Phone:
Type: Mailing
Providence Centralia Hospital, 914, South Scheuber Road, Centralia, Lewis County, Washington, 98331, United States
CENTRALIA, WA 98531
Phone: (360) 330-8976
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-07-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130722000493 | I | Internal Medicine | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 400 | 198 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 355 | 164 | $0 |
| 99239 | Hospital discharge day management, more than 30 minutes | 216 | 211 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 74 | 74 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 56 | 56 | $0 |
Insurance plans in this area (ZIP 97208)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H E M A T O L O G Y/ O N C O L O G Y | WA | |
| Gynecological Oncology, Obstetrics/Gynecology | CA | |
| - | OR | |
| Certified Nurse Midwife (Cnm) | WA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | WA | |
| - | WA | |
| Physician Assistant | WA | |
| Mental Health Counselor | WA | |
| - | WA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | WA |
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